Pediatric Nursing and Health Care

[Pages:202]LECTURE NOTES

For Nursing Students

Pediatric Nursing and Health Care

Teklebrhan Tema Tsegaye Asres

Jimma University

In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education

2003

Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00.

Produced in collaboration with the Ethiopia Public Health Training Initiative, The Carter Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education.

Important Guidelines for Printing and Photocopying Limited permission is granted free of charge to print or photocopy all pages of this publication for educational, not-for-profit use by health care workers, students or faculty. All copies must retain all author credits and copyright notices included in the original document. Under no circumstances is it permissible to sell or distribute on a commercial basis, or to claim authorship of, copies of material reproduced from this publication. ?2003 by Teklebrhan Tema and Tsegaye Asres All rights reserved. Except as expressly provided above, no part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission of the author or authors.

This material is intended for educational use only by practicing health care workers or students and faculty in a health care field.

Pediatric Nursing and child health care

Preface

This lecture note on pediatric and child health is written for nurses at diploma level by considering the epidemiology and the burden of illness on younger age groups. In this lecture note, the authors present concise summaries of the evidence that has been published in the scientific journals and texts which have a similar profile in the Ethiopian context. Since the authors have had so many years of teaching experience, emphasis is given on those lessons learned from experience.

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Pediatric Nursing and child health care

Acknowledgments

The authors acknowledge The Carter Center (EPHTI) Addis Ababa, Ethiopia for their financial support and encouragement.

Dr. Hailu Nida, assistant professor of pediatric and child health Jimma University, School of Medicine and Sr. Bosna Tebeje, Lecturer, at Jimma University School of Nursing deserve special thanks for their invaluable comments on the lecture note at the intra-institutional work shops in Agaro.

Nega Assefa and Sr. Meselech Asigid both from Alemaya University and Yosief Tsige from Jimma University need to receive warm appreciations for their immense contribution during the inter-institutional work shops in Addis Ababa.

Last but not least, students at Jimma University, particularly in the school of nursing, deserve special thanks for their active participation during the process of testing this manual in the class-room setting.

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Pediatric Nursing and child health care

TABLE OF CONTENTS

Preface

i

Acknowledgement

ii

Table of content

iii

List of tables and figures

viii

Abbreviations

ix

CHAPTER ONE: INTRODUCTION TO CHILD

1

HEALTH

1.1 Introduction

1

1.2 Safe motherhood and antenatal care.

2

1.3 Age and diseases pattern

5

1.4 Health priorities in children

7

1.5 Care of the Under-Fives

9

Study Questions

12

CHAPTER TWO: HISTORY TAKING AND

13

PHYSICAL EXAMINATION

2.1. History taking and approach

13

2.2. Review of System

17

2.3. Physical Examination

18

Study Questions

23

CHAPTER THREE: ESSENTIAL NURSING CARE

24

FOR HOSPITALIZED CHILDREN

3.1. Administration of drugs

24

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Pediatric Nursing and child health care

3.2. Indications and use of naso-gastric tube

27

3.3. Care of child under specific conditions

32

3.4. Tracheostomy Care

36

Study Questions

40

CHAPTER FOUR: CARE OF THE NEW BORN

41

4.1. Care of normal new born

41

4.2. Causes of low birth weight

44

4.3. Perinatal and infant infections

51

4.4. Post neonatal and infant morbidity

52

4.5 Neonatal resuscitation

52

4.6 Fever

54

4.7 Convulsions

55

4.8 Feeding Recommendations during sickness

57

and health

Study Questions

59

CHAPTER FIVE: CONGENITAL ABNORMALITIES 60

5.1. Introduction

60

5.2. Types of commonest congenital anomalies

61

5.3. Umbilical hernia

65

5.4 Congenital Hypertrophic pyloric stenosis

66

5.5 Phimosis and paraphimosis

68

5.6. Spinal Bifida

69

5.7. Hydrocephalus

71

5.8. Neonatal Jaundice

73

Study Questions

75

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Pediatric Nursing and child health care

CHAPTER SIX: NORMAL GROWTH AND

76

DEVELOPMENT

6.1. Growth

77

6.2. Development

79

Study Questions

84

CHAPTER SEVEN: NUTRITION AND

85

NUTRITIONAL DEFICIENCIES

7.1. Normal feeding pattern

86

7.2. Assessment of Nutritional status

89

7.3. Protein Energy Malnutrition

91

7.4. Micronutrient and its deficiency

95

Study Questions

102

CHAPTER EIGHT: ACUTE RESPIRATORY

103

INFECTIONS

8.1. Introduction

104

8.2. Management of Children with ARI

105

8.3. Antbiotic Treatment

110

8.4. Home Care

111

8.5. Referral Criteria

112

8.6. Croup or Obstructive Laryngitis

112

8.7 Tonsilitis, Pharyngitis

114

8.8. Chronic Tonsilitis and Adenoditis

115

8.9. Ear Infections

116

Study Questions

118

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Pediatric Nursing and child health care

CHAPTER NINE: CONTROL OF DIARRHEA

119

9.1. Introduction

119

9.2. Types of diarrhea

120

9.3. Why is diarrhea dangerous?

120

9.4. How does diarrhea cause dehydration?

121

9.5. Treating Diarrhea

121

9.6. Prevention of dehydration

122

9.7. Feeding

122

9.8. Oral rehydration therapy

123

9.9. Assessment of a child with diarrhea

124

9.10 Treatment of Diarrhea

129

9.11 To treat diarrhea at home use treatment plan A 130

Study Questions

135

CHAPTER TEN: SYSTEMIC DISEASES

136

10.1. Cardiovascular system (CVS) disorder

136

10.2. Central nervous system Diseases

144

10.3. Epilepsy/ Seizure

147

10.4. Congenital heart Disease

150

10.5. Nephritic Syndrome

153

10.6. Urinary Tract Infection

155

10.7. Tuberculosis

157

10.8. Disease of the Skin

160

10.9. Other problems

163

10.10. Ophthalmic neonatrum

165

10.11. Congenital Syphilis

167

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